ACAM Integrative Medicine (IM) Blog

Zinc and Copper Levels Are Key Factors in ADHD/ADD

Research has found that many children and young adults with ADHD/ADD are deficient in zinc. Zinc is found in the brain's hippocampus and interacts with other chemicals to send messages to the sensory brain center, enhancing memory and thinking skills. It has a significant effect on visual memory, learning, emotional and behavioral state and overall cognitive function. A deficiency may result in learning impairments, poor memory and emotional and behavioral problems.

A study carried out on 135 males aged between 3 and 20 with a history of aggressive behavior found that many of the subjects were likely to have high levels of copper and low levels of zinc compared with non-aggressive people. Zinc and copper compete for absorption. Because of this inverse relationship, zinc supplements can be effective for lowering copper levels. Proper mineral balance is essential for the production of chemical signals in the brain that influence behavior. Both copper and zinc tend to be concentrated in the hippocampus of the brain, which is the area known to be associated with stress response.

Since it usually takes two to three months to overcome a copper-zinc imbalance, treatment with zinc supplements should be continued for a minimum of four months before determining effectiveness. Zinc deficiency can result from exposure to heavy metal toxins, such as cadmium (usually from exposure to cigarette smoke) and lead, which prevent its absorption. Poor dietary habits such as excessive consumption of sugar or carbohydrates are also known to reduce zinc absorption.

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Doc Howard

Dr.  Julie Howard is CEO of The Howard Clark Corporation and founder/director of Youth Essential Solutions, Head Out Rehabilitation Camp, and Texas Preparatory Academy. For more information visit, http://docjhoward.com/. 

Meet One of ACAM's Gold Corporate Sponsors: Thorne Research

Thorne Research has been in business for over 25 years and provides a wide spectrum of dietary supplements for all walks of life. They believe in the use of capsules versus tablets as encapsulation of dietary supplements offers significant advantages, such as the ability to provide greater purity and bioavailability of nutrients, as described on their website, www.thorne.com.

Their products range from formulas that help you stay healthy as you age, to nutritional support to enhance the body's detoxification process, and even products for pets. 

As a Gold Corporate Sponsor Thorne receives advance selection of booth space, a half page ad in ACAM's Conference Guide and logo placement in conference promotional mailings, amongst many other benefits.

ACAM looks forward to seeing what Thorne will bring to ACAM's next conference in April 2010 to be held in San Diego, CA.

Naturopathic Medical Doctor Gina Nick Treating Patients With Chronic Pain

ACAM member Gina Nick, NMD, PhD, is a frequent guest blogger for ACAM's Integrative Medicine Blog and is the Founder and Medical Director of LTP Natural Medical Center in Laguna Beach, CA.  

She was recently featured with one of her patients on a PBS special about how Naturopathic Medicine treats chronic pain. Here's the clip:

Visit our Integrative Medicine Blog frequently for more posts by Dr. Gina.

A Little Citrus Might Go a Long Way!

The scourge of gout remains highly prevalent. Its incidence is on the rise, and the predominant clinical manifestations are as challenging as ever to safely manage. When a gout attack strikes, often at the least convenient of times, the affected host is overcome by misery, if not incapacitated, as was the case during antiquity. Although an estimated 3 million Americans experienced a gout attack in 2005, the range of available treatment options — for both acute intervention and prophylaxis — is virtually unchanged from 40 years ago. While nonsteroidal antiinflammatory drugs, corticosteroids (oral, intravenous, and intraarticular), colchicine and allopurinol have established therapeutic benefit, they each possess a considerable side-effect profile.

Older age and underlying renal insufficiency are 2 important risk factors for iatrogenicity arising from gout medication. These are, nonetheless, key demographic and clinical features of the population segment at risk to develop incident gout and to experience recurrent gout flares. Novel therapeutic strategies, particularly those that might offer incremental clinical benefit without the counterbalancing peril of treatment-related toxicity, are sorely needed. A recent development was the arrival of febuxostat, a novel xanthine oxidase inhibitor, that would potentially offer greater safety over traditional allopurinol, with its primary hepatic (febuxostat) rather than renal (allopurinol) metabolism. Although its therapeutic upside was demonstrated in a randomized clinical trial, approval from the US Food and Drug Administration has seemingly been elusive. Caution in the drug approval process may be influenced by lingering concern about safety, coming on the coattails of the contemporary experience with selective inhibitors. These arthritis agents were ultimately recognized to engender an increase in cardiovascular morbidity and mortality. It is only with postmarketing surveillance in an expanded population that quantitatively richer pharmacoepidemiologic data may come forward.

Interestingly, the lay public has maintained a longstanding interest in complementary and alternative therapies, including the use of vitamins, to manage or prevent a broad range of disorders. Such an option might be especially germane to gout (and hyperuricemia) if a therapeutic agent is found to offer clinical benefit with a concomitant diminution (rather than an escalation) in iatrogenic risk! In such a scenario, not only might the attention of the public be galvanized, but the medical community might simultaneously generate enthusiasm. The key is to strive for clear and compelling scientific evidence culled from well designed and rigorously analyzed clinical studies. In this vein, vitamin C or ascorbic acid, might fit the billing.

Integrative Mesothelioma Treatment Modalities Emerging

Mesothelioma is a rare but aggressive cancer that is almost exclusively linked to an exposure to the building and insulating material, asbestos. During the course of manufacturing, installing, or break-down of asbestos-containing materials, a fine particulate – composed of microscopic and needle-like fibers – may be released into the surrounding air. After being inhaled or ingested, those fibers can embed themselves deep into the mesothelium, which is a membranous lining that protects the lungs, heart and stomach, and which also lines the thoracic and abdominal cavities. The fibers can cause irritation, lung scarring (asbestosis) and eventual malignancy, known as malignant mesothelioma.

One of the most unfortunate hallmarks of mesothelioma is the fact that it is often asymptomatic, remaining undiagnosed for an astonishing 20 to 50 years. By the time the cancer is diagnosed, it has usually reached Stage III or Stage IV, and is often not receptive to traditional treatment. Curative surgery is only feasible in Stage I mesothelioma, and such early detection is very rare. In later stages, surgery may be attempted to remove some of the cancer, usually in combination with radiation therapy and chemotherapy. Clinical studies have shown that a trimodal approach to mesothelioma treatment is generally most effective, but most patients still have a life expectancy of only 18 months after diagnosis. In later stages, many mesothelioma patients find that the benefits of palliative chemotherapy and radiotherapy do not outweigh the side effects and discomfort that accompany these treatments, and therefore opt not to pursue conventional methods of cancer treatment.

For these reasons, homeopathic and other alternative treatments have been proven popular with mesothelioma patients. Alternative approaches can be used as stand-alone treatments to reduce the pain and symptoms of the disease, or as complementary therapy intended to help ease the side effects of more conventional therapies.

Some of the most popular alternative therapies include massage, yoga, acupuncture and acupressure (including reflexology), traditional Chinese medicine (TCM), use of select herbs as a nebulizer, nutritional regimens, supplements, meditation or hypnosis, and aromatherapy. TENS therapy, or transcutaneous electrical nerve stimulation, is also becoming popular. This therapy involves no drug interactions, is non-invasive, and has no known harmful side effects. In TENS therapy, pain relief is achieved by attaching electrodes to specific areas on the patient's skin and administering an electrical current. TENS is believed by some to stimulate the body's natural production of endorphins, which are analgesics.

Acupuncture, similarly, is used to relieve pain, as well as to ameliorate some of the side effects,  including nausea, commonly experienced by patients undergoing chemotherapy and radiation. The same is true of meditation and hypnosis, which some patients claim can help them alleviate their pain. Other therapies, such as aromatherapy, massage and practicing the ancient exercise of yoga, help primarily by relaxing the patient and improving their overall mind-body wellness. Herbal treatments are gaining in popularity and efficacy as well, as they become better understood, and evidence is emerging that certain herbs, such as licorice root, American ginseng and oldenlandia can ameliorate advanced lung cancer symptoms. Nutritional approaches, such as supplements, herbal teas or tinctures, and a change in diet can help improve the patient's overall health as well as targeting both specific symptoms of mesothelioma and the side effects of its conventional treatments.

An increasing number of physicians and oncologists are recognizing the value of alternative therapies, and integrating them into the treatment plan. Each treatment program is individually tailored, in order to best address the individual patient's needs, symptoms, advancement of disease, and wishes. Integrative medicine, as the combination of traditional cancer treatments and more holistic approaches has come to be known, is considered by many health care professionals to be the best path to superlative patient care. Indeed, the incorporation of proven alternative therapies into a standard medical treatment regimen can yield more satisfying results for patients and their caregivers than can reliance upon conventional modalities alone, and it is likely that future preferred mesothelioma treatment methods will be integrative in nature.

Meet One Of Our Corporate Sponsors: The McGuff Companies

McGuff has been associated with ACAM for 30 years and is one of our Legacy Corporate Sponsors, our highest level of corporate sponsorship. The McGuff Companies is comprised of 3 companies each designed to serve a different factor of the medical community.

• McGuff Company, Inc. is dedicated to serving physicians, pharmacies, hospitals and veterinarians with thousands of competitively priced pharmaceutical and medical products.

• McGuff Compounding Pharmacy Services, Inc. serves patients with prescriptions for compounded medications, physicians and clinical trials. Their mission statement is: "To retain our uncompromising passion for quality pharmaceuticals and customer satisfaction"

• McGuff Pharmaceuticals, Inc. serves drug wholesalers, hospitals, drug research facilities and clinical trials. They are FDA inspected and competent in FDA current Good Manufacturing Practices (cGMP) and International Organization for Standardization Quality Systems.

Last year McGuff received ACAM's Corporate Vision Award at our Spring Conference in Orlando, FL. Over the years McGuff has provided financial support, technical assistance and a demonstrated willingness to help ACAM whenever needed.

As a Legacy Corporate Sponsor McGuff receives top priority consideration for booth space at our conferences and a full page ad in our Conference Guide, amongst several other benefits.

ACAM looks forward to working with McGuff Companies for many more years to come.

This Week The Spotlight Is On...

ACAM member, Charles C. Adams, of Ringgold, GA! Here he is at ACAM's recent conference in Las Vegas talking a little bit about his practice at the Full Circle Medical Center.

Dr. Adams has received several honors including, the 2004 Practitioner of the Year from CHEO (the Complementary Health Education Organization), in 2005 "DAN" doctor from Defeat Autism Now and the AMA Physicians Recognition Award for continuing to receive in excess of 100 hours of continuing medical education each year.

He attended the University of Tennessee medical school in Memphis, TN and completed his Internal Medicine Residency at the University of Tennessee Erlanger Hospital. He maintains his board eligibility in Internal Medicine and is trained and certified by ACAM in chelation therapy.

He and his wife of 20+ years and their 3 children reside on Lookout Mountain, TN.

What Would You Like To See At The Next ACAM Conference?

We're extending our Needs Assessment Giveaway through next week, December 14, to collect more input from you, the medical community. ACAM strives to provide rigorous educational offerings. This is your field, tell us what you'd like to learn. What would benefit you and your practice? Help us shape the future of the industry by completing the Needs 2010 form online at: http://www.surveymonkey.com/s.aspx?sm=P1IdM6FIrZ1rzEBxVSyYjA_3d_3d.

PRIZES:   To thank you for providing us with your feedback, ACAM will be giving away the following prizes to randomly chosen individuals who complete the online form and provide their name and email address.

- 1 ACAM annual membership

- 1 Complimentary Spring 2010 conference registration (General Session) 

- 50% off Spring 2010 conference registration fees (General Session)

- $100 off Spring 2010 conference registration fees (General Session)

Promotion ends:  December 14, 2009

Drawing Date: December 18, 2009 (winner will be announced on Twitter/notified by e-mail

Tinnitus: Characteristics, Causes, Mechanisms & Treatments

INTRODUCTION

Tinnitus is defined as a phantom auditory perception-it is a perception of sound without corresponding acoustic or mechanical correlates in the cochlea. Tinnitus represents one of the most common and distressing otologic problems, and it causes various somatic and psychological disorders that interfere with the quality of life. A population-based study of hearing loss in adults aged 48 to 92 years found that tinnitus had a prevalence of 8.2% at baseline and an incidence of 5.7% during a 5-year follow-up. The prevalence of tinnitus increases with age.

Tinnitus also represents a common symptom among children with hearing loss. Tinnitus is a subjective phenomenon that is difficult to evaluate objectively, with it being measured, quantified, and described only based on the responses of patients. Although tinnitus can have many different causes, it most commonly results from otologic disorders, with the most common cause believed to be noise-induced hearing loss. The various therapeutic approaches to tinnitus have produced mixed results, and hence it is generally assumed that tinnitus has diverse physiological causes.

CLINICAL MANIFESTATIONS

CHARACTERISTICS OF TINNITUS

The sound perceived by those with tinnitus can range from a quiet background noise to a noise that is audible over loud external sounds. Tinnitus is generally divided into two categories: objective and subjective. Objective tinnitus is defined as tinnitus that is audible to another person as a sound emanating from the ear canal, whereas subjective tinnitus is audible only to the patient and is usually considered to be devoid of an acoustic etiology and associated movements in the cochlear partition or cochlear fluids. Many physicians use the term tinnitus to designate subjective tinnitus and the term somatosound to designate objective tinnitus.

The sounds associated with most cases of tinnitus have been described as being analogous to cicadas, crickets, winds, falling tap water, grinding steel, escaping steam, fluorescent lights, running engines, and so on. It is believed that these types of perception result from abnormal neuronal activity at a subcortical level of the auditory pathway.

The pattern characterizing tinnitus is related to the library of patterns stored in auditory memory and also, via the limbic system, associated with emotional states. The characteristics of tinnitus are generally unrelated to the type or severity of any associated hearing impairment, and thus the latter offers little diagnostic value. Most tinnitus patients match their tinnitus to a pitch above 3 kHz. The tinnitus characterizing Meniere's disease, described as roaring, matches a low-frequency tone that is usually from 125 to 250 Hz. However, tinnitus in the advanced "burned-out" stage of Meniere's disease is often higher in pitch and tonal in quality.

Most patients with both tinnitus and hearing loss report that the frequency of the tinnitus correlates with the severity and frequency characteristics of their hearing loss, and that the intensity of the tinnitus is usually less than 10 dB above the patient's hearing threshold at that frequency. Some patients who have central auditory processing disorders and have difficulties understanding speech in noise report experiencing tinnitus even though their pure-tone audiometric thresholds are normal.

Less prevalent forms of tinnitus, such as those involving well-known musical tunes or voices without understandable speech, occur among older people with hearing loss and are believed to represent a central type of tinnitus involving reverberatory activity within neural loops at a high level of processing in the auditory cortex.

Somatic tinnitus is a type of subjective tinnitus in which the frequency or intensity is altered by body movements such as clenching the jaw, turning the eyes, or applying pressure to the head and neck.

Reports that tinnitus is louder upon awakening suggest the involvement of somatic factors, such as bruxism. Reports that tinnitus vanishes during sleep but returns within a few hours further suggest that psychosomatic factors, such as neck muscle contractions occurring in an upright position or jaw clenching, play etiological roles.

Because objective tinnitus (which is audible to another person) represents the semantic opposite of subjective tinnitus, a better nosological approach might be to use the term somatosound instead of objective tinnitus irrespective of whether the sounds are audible to others, reserving the term tinnitus for the perception of sound in the absence of any acoustic source. Thus, "tinnitus" would describe cases previously diagnosed as subjective tinnitus. Objective tinnitus might be vascular or mechanical in origin. Objective tinnitus of vascular origin could be a referred bruit from stenosis in the carotid or vertebrobasilar system. Objective mechanical tinnitus is due to abnormal muscular contraction of the nasopharynx or middle ear, as can occur in palatal myoclonus. Pulsatile tinnitus can also manifest subjectively as an increased awareness of blood flow in the ear. Indeed, the cause of somatosensory pulsatile tinnitus syndrome is not vascular, with the syndrome deriving from cardiac-synchronous somatosensory activation of the central auditory pathway or the failure of somatosensory-auditory central nervous system (CNS) interactions to suppress cardiac somatosounds. Pulsatile tinnitus superimposed on steady tinnitus could result from the pulsation of blow flow with the spiral capillary of the basilar membrane.

From our offices...

From: Drew McGray - VP Marketing for ACAM

Conference time may have passed for ACAM attendees, but it continues for us in the office. ACAM Management recently returned from the Blackbaud Conference for Nonprofits in Charleston, SC.  Blackbaud (formerly Kintera) is the software company that powers ACAM's business infrastructure/marketing and membership management solutions. 

The annual conference unites over 1,000 non-profit management professionals for three days of learning, strategy and development.  We took home some very exciting information, from change-management strategy, to new ways to reach more people via online and offline tactics.  We attended special workshops on fund raising as well. 

At ACAM, we strive to provide multiple channels and access points for information that best represents the diverse range of constituents we serve.  If you are tech-savvy, there are many ways to leverage ACAM technology to serve you.  However, if you are not, you can be rest assured we will either put technology to work for you, or give you any coaching you may require.  We have dedicated staff who can help you use online resources to market your practice, improve efficiency, and reach more patients with ease.  

Don't forget to keep us in the loop about events happening in your professional life.  Every day, we generate tweets, blog posts, and raise awareness of the activities our members are participating in.  If you remodeled your practice, won an award, have new research to present, etc, let us know! In fact, it's as easy as completing an online form to let us know. Try it today.